ROUTINE PREOPERATIVE TEACHING OF THE ADULT PATIENT 

 see also:

• Laryngectomy Home Care Booklet
• Total laryngectomy (surgical protocol)
• Tracheoesophageal puncture (video attached)

return to: Speech Pathology Protocols

Objective:

• Patient/family will verbalize understanding of anatomical and physiological changes following total laryngectomy.
• Patient/family will be introduced to laryngeal speech methods and to devices and products typically helpful to laryngectomees.

Content:

• Basic overview of head and neck anatomy and physiology as pertaining to voice, speech, smell, air filtration/humidification, and swallowing.
• Compare to post-total laryngectomy anatomy and physiology utilizing diagrams and models. Stress importance of safety around bodies of water, poor sense of smell, and benefits of covering the stoma with a filter.
• Educate regarding potential swallowing difficulties following surgery.
• Educate patient regarding potential methods of communication esophageal speech, tracheoesophageal voice prosthesis, artificial larynx (electrolarynx, UltraVoice system, etc.), and augmentative/alternative communication (AAC) devices (Lightwriter, DynaVox, etc.).
• Show videos of laryngectomees using an artificial larynx, esophageal speech, AAC device, and tracheoesophageal speech.
• Further discussion of pros and cons of each communication method.
• Show patient sample products such as stoma filter, shower shield, and medical alert bracelet.
• Encourage patient to express feelings regarding body image communication, or lifestyle changes to speech-language pathologist and other health care providers.